The gut microbiome in bullous pemphigoid: implications of the gut-skin axis for disease susceptibility

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Xiaolin Liu - , Max Planck Institute for Evolutionary Biology (Author)
  • Nina van Beek - , University of Lübeck (Author)
  • Aleksa Cepic - , Max Planck Institute for Evolutionary Biology (Author)
  • Nadia A Andreani - , Max Planck Institute for Evolutionary Biology (Author)
  • Cecilia J Chung - , Max Planck Institute for Evolutionary Biology (Author)
  • Britt M Hermes - , Max Planck Institute for Evolutionary Biology (Author)
  • Kaan Yilmaz - , University of Lübeck (Author)
  • Sandrine Benoit - , University Hospital of Würzburg (Author)
  • Kossara Drenovska - , Medical University Sofia (Author)
  • Sascha Gerdes - , Kiel University (Author)
  • Regine Gläser - , Kiel University (Author)
  • Matthias Goebeler - , University Hospital of Würzburg (Author)
  • Claudia Günther - , Department of Dermatology (Author)
  • Anabelle von Georg - , University of Lübeck (Author)
  • Christoph M Hammers - , University of Lübeck (Author)
  • Maike M Holtsche - , University of Lübeck (Author)
  • Dimitra Kiritsi - , University Medical Center Freiburg (Author)
  • Franziska Schauer - , University Medical Center Freiburg (Author)
  • Beke Linnenmann - , University of Lübeck (Author)
  • Laura Huilaja - , University of Oulu (Author)
  • Kaisa Tasanen-Määttä - , University of Oulu (Author)
  • Snejina Vassileva - , Medical University Sofia (Author)
  • Detlef Zillikens - , University of Lübeck (Author)
  • Christian D Sadik - , University of Lübeck (Author)
  • Enno Schmidt - , University of Lübeck (Author)
  • Saleh Ibrahim - , University of Lübeck (Author)
  • John F Baines - , Max Planck Institute for Evolutionary Biology (Author)

Abstract

Bullous pemphigoid (BP) is an autoimmune blistering disease that primarily affects the elderly. An altered skin microbiota in BP was recently revealed. Accumulating evidence points toward a link between the gut microbiota and skin diseases; however, the gut microbiota composition of BP patients remains largely underexplored, with only one pilot study to date, with a very limited sample size and no functional profiling of gut microbiota. To thoroughly investigate the composition and function of the gut microbiota in BP patients, and explore possible links between skin conditions and gut microbiota, we here investigated the gut microbiota of 66 patients (81.8% firstly diagnosed) suffering from BP and 66 age-, sex-, and study center-matched controls (CL) with non-inflammatory skin diseases (132 total participants), using 16S rRNA gene and shotgun sequencing data. Decreased alpha-diversity and an overall altered gut microbial community is observed in BP patients. Similar trends are observed in subclassifications of BP patients, including first diagnoses and relapsed cases. Furthermore, we observe a set of BP disease-associated gut microbial features, including reduced Faecalibacterium prausnitzii and greater abundance of pathways related to gamma-aminobutyric acid (GABA) metabolism in BP patients. Interestingly, F. prausnitzii is a well-known microbiomarker of inflammatory diseases, which has been reported to be reduced in the gut microbiome of atopic dermatitis and psoriasis patients. Moreover, GABA plays multiple roles in maintaining skin health, including the inhibition of itching by acting as a neurotransmitter, attenuating skin lesions by balancing Th1 and Th2 levels, and maintaining skin elasticity by increasing the expression of type I collagen. These findings thus suggest that gut microbiota alterations present in BP may play a role in the disease, and certain key microbes and functions may contribute to the link between gut dysbiosis and BP disease activity. Further studies to investigate the underlying mechanisms of the gut-skin interaction are thus clearly warranted, which could aid in the development of potential therapeutic interventions.

Details

Original languageEnglish
Article number1212551
Pages (from-to)1212551
JournalFrontiers in immunology
Volume14
Publication statusPublished - 2023
Peer-reviewedYes

External IDs

PubMedCentral PMC10668026
Scopus 85177668987
ORCID /0000-0002-4330-1861/work/151982048

Keywords

Keywords

  • Aged, Disease Susceptibility, Gastrointestinal Microbiome/physiology, Humans, Pemphigoid, Bullous, Pilot Projects, RNA, Ribosomal, 16S/genetics, gamma-Aminobutyric Acid